DR. EDWARD S. KWAK M.D. NPI 1568514412

NPI Information

NPI: 1568514412
Provider Name: DR. EDWARD S. KWAK, M.D.
Classification: Otolaryngology - 207YS0123X
Entity Type: Individual

Specialization: Facial Plastic Surgery

PECOS Registration: Yes

CLIA Number: 33D2118182

Address:
737 PARK AVE APT 1D
NEW YORK, NY
ZIP 10021
Phone: (212) 229-1100
Get Directions

DR. Edward S. Kwak, M.D. is a facial plastic surgery otolaryngology in New York, NY with 23 years of experience. The provider is an otolaryngologist who specializes in facial plastic surgery. DR. Edward S. Kwak, M.D. NPI is 1568514412. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2001

The provider's business location address is:

737 PARK AVE APT 1D
NEW YORK, NY
ZIP 10021-264
Phone: (212) 229-1100
Fax: (212) 229-1105

The NPI 1568514412 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 33D2118182 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/18/2007 and was last updated on 1/9/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		236600	NEW YORK	No
2	207YS0123X	Otolaryngology	Facial Plastic Surgery	236600	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	02877961	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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